Jamison Spencer, DMD, MS The Craniofacial Pain Centers Boise, ID, Denver, CO
THE DEVELOPMENT OF THE SILENT SLEEP
About a year and a half ago a colleague of mine inquired if there were any oral appliances available on the market that could be used in countries where CPAP therapy was impractical due to the expense of the CPAP equipment. Since custom-made appliances would also be too expensive and difficult to acquire in such areas, I started looking at various non-custom appliances. I soon realized that all of the non-custom appliances on the market had the same problems—they required boiling to be fit; they were overly bulky and lacked tongue space and they were difficult to alter. I started designing the Silent Sleep in an attempt to improve on these shortcomings.
THE SILENT SLEEP IS UNIQUE
There are a number of factors that make the Silent Sleep unique. The biggest difference between the Silent Sleep and other non-custom appliances is the way the Silent Sleep is customized. The Silent Sleep is typically fit using GC Denture Reline material, rather than using a boil and bite material. This allows the appliance to be fit in just a few minutes, without the potential dangers and problems associated with boiling water in the operatory. The use of the syringed GC Reline material also allows the appliance to easily be re-fit, adjusted or relined. This means that the Silent Sleep can be used in cases where other appliances would not be indicated, such as in the treatment of children who are actively growing or in patients currently in orthodontics. Also, the Silent Sleep is only retained on the posterior teeth. This allows for maximum tongue space and minimizes the bulk of the appliance. It also means that no pressure is placed on the anterior teeth which may be helpful in cases where the anterior teeth are periodontally compromised.
USING THE SILENT SLEEP
The main application of the Silent Sleep will be as a temporary or interim appliance while a custom made appliance is fabricated.
The Silent Sleep may also be used as a spare appliance for travel or camping or as a low cost alternative to custom-made appliances. The Silent Sleep may also be fit immediately in the sleep lab in patients that are found during the CPAP titration to be CPAP intolerant.
FITTING AND MODIFYING THE SILENT SLEEP APPLIANCE
The Silent Sleep kit comes with several bite gauges. A “George Gauge” may also be used. The bite gauge is placed between the anterior teeth and an initial treatment position is determined. The Silent Sleep shell is then filled with the Reline material or other material of the dentist’s choice (such as thermal plastic or acrylic) and placed on the lower teeth. Once in position, the patient bites onto the bite gauge which brings the mandible into the initial position while the Reline material sets. After the Reline material is set any excess material may be trimmed with scissors or even with a slow speed hand piece. If the mandibular position needs to be changed, either anterior or posterior, the dentist simply removes the Reline material from the maxillary portion of the appliance and then re-fits the appliance in the new position. Using the included bite gauges makes this straightforward and predictable.
We have had many positive experiences using the Silent Sleep. We have had patients who we fit on the day of their initial exam who called to report relief of snoring and improved sleep the next day. We have also fit patients with the Silent Sleep to use as a trial appliance. The feedback from users of the Silent Sleep is overwhelmingly positive. I wear one myself and I find it to be very comfortable and effective.
CUSTOM MADE ORAL APPLIANCES
We continue to use several excellent custom fabricated appliances in the treatment of the majority of our CPAP intolerant patients. We choose the appliance based on the treatment goals, patient’s dental condition and other factors. Unfortunately, many patients who are referred to me are unable to afford custom made appliances. In these cases, it is nice to have an alternative.
Fitting the Silent Sleep
To learn more about the Silent Sleep and to watch full length videos of Dr. Spencer fitting a Silent Sleep appliance, go to www.mysilentsleep.com or call 1-888-872-8538.
1. Silent Sleep: Place the tray in the mouth to check initial fit.
2. Begin syringing the Reline material, starting at the retention holes.
3. Fill the entire tray with the Reline Material.
4. Place the filled tray over the mandibular teeth.
5. Use the Silent Sleep bite gauge to bring the patient’s mandible into proper anterior position.
6. The Silent Sleep with set Reline material.
7. The customized Silent Sleep.